Introduction
In health care, the accurate measurement and analysis of quality indicators are critical to evaluating and improving patient outcomes. The Nurse-Sensitive Quality Indicator Dashboard for Adams 5, an inpatient rehab unit, is a useful tool for measuring different performance metrics on a quarterly basis. This paper seeks to analyze the performance trends in the dashboard, pointing out areas of good performance and identifying areas for improvement. By analyzing statistical data and trends, the paper will focus on the choice of a Nurse-Sensitive Quality Indicator that needs to be addressed and the development of a nursing action plan based on evidence-based best practices. The focus on the areas of opportunity, like prevention of pressure ulcers, is aimed at improving patient safety, satisfaction, and the overall quality of care in the unit. This analysis emphasizes the role of proactive quality management strategies in the pursuit of excellence in healthcare delivery.
Performance and Opportunity Analysis
The Nurse-Sensitive Quality Indicator Dashboard for Adams 5, the inpatient rehab unit, gives a general overview of performance measures for four quarters. In a number of parameters, the unit shows good performance. Importantly, the Nursing Hours Per Patient Day (NHPPD) was stable, with values close to or below target values. For instance, in Q2 FY09, NHPPD was 6.56, which was higher than the target of 6.69. Likewise, patient satisfaction indicators RN Courtesy and Promptness consistently scored high, with RN Courtesy reaching 88.85% in Q2 FY09, just below the target of 92.70%. Nevertheless, there are areas of concern, especially in pressure ulcer prevention. In all quarters, the percentage of patients with pressure ulcers consistently exceeded target levels, for example, 20.00% in Q3 FY09 against a target of 2.84%. This means that patient safety and quality of care require the improvement of pressure ulcer prevention practices (Kottner et al., 2020).
Selection of Indicator for Improvement: Pressure Ulcers (%PRSSULC)
Given the value attached to patient safety and quality of care, the chosen metric for performance improvement is Pressure Ulcers (%PRSSULC). The high-perpetuated gap between actual and target %PRSSULC indicates the requirement to enhance the prevention and care of stress ulcers. For example, in Q4 FY09, %PRSSULC was 13.37%, an amount that was far much above the intended percent of 2.84%. This points to the importance of preventive efforts aimed at minimizing the risk of pressure ulcers and improving patient outcomes (Kottner et al., 2020).
Nursing Action Plan
A comprehensive nursing action plan is needed to tackle the pressure ulcers issue adequately. To begin with, pressure ulcer prevention protocols based on evidence should be introduced. In Q3 FY09, the actual value of %PRSSULC was 20.00% which was higher than the target which was 2.84%. Protocols are to point out the patient repositioning, skin assessments, moisture management, and nutritional optimization. Besides, staff training and education is necessary. Given the constant gap between the actual and target %PRSSULC, the regular training sessions should focus on the prevention strategies, correct skin assessment techniques and the use of pressure-relieving devices. Interdisciplinary collaboration is also important. As %PRSSULC is always higher than the predetermined goals, cooperation of nursing, wound care specialists and other disciplines can make timely interventions and holistic care possible.
Best Practices Supporting the Nursing Plan:
EBP best practices should guide the nursing plan. Guidelines should also come from authoritative sources such as the National Pressure Ulcer Advisory Panel, and Agency for Healthcare Research and Quality. Skin assessment with standardized tools such as the Braden Scale is a way of identifying patients at risk and prevention interventions implemented accordingly. Patient and family education is another essential component of pressure ulcer prevention. Due to the persisting discrepancy between observed and target %PRSSULC, patient and family participation in proactive prevention strategies, targeting mobility, nutrition, hydration, and skin care, has an ability to reduce the number of pressure ulcers and achieve better results for the patients as a whole (Agency for Healthcare Research and Quality, 2020).
Conclusion
In summary, the issue of pressure ulcers requires a comprehensive nursing plan of action underpinned by evidence-based practices in order to ensure patient safety and the quality of care in the inpatient rehab unit. By putting in place focused interventions and interprofessional collaboration, the unit can effectively manage the risk of pressure ulcers and enhance overall patient outcomes.
References
Kottner, J., Cuddigan, J., Carville, K., Balzer, K., Berlowitz, D., Law, S., … & Haesler, E. (2020). Pressure ulcer/injury classification today: An international perspective. Journal of Tissue Viability, 29(3), 197-203. https://www.academia.edu/download/104348914/j.jtv.2020.04.00320230718-1-aybinb.pdf
Agency for Healthcare Research and Quality (AHRQ). (2019). Preventing pressure ulcers in hospitals. https://www.ahrq.gov/sites/default/files/publications/files/putoolkit.pdf
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